Chest imaging: diaphragmatic hernia: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Chest imaging: diaphragmatic hernia

Sample item

A newborn in respiratory distress has a scaphoid abdomen, and the chest radiograph shows bowel loops in the left hemithorax with the mediastinum shifted to the right and a nasogastric tube coiled in the chest. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Congenital diaphragmatic hernia (Bochdalek)

A Bochdalek hernia is a posterolateral diaphragmatic defect, usually on the left, allowing bowel into the chest and causing pulmonary hypoplasia and shift of the mediastinum. The nasogastric tube lies in the chest if the stomach has herniated. Treatment includes stabilisation followed by surgical repair.

Option by option

  • A. Congenital lobar emphysema

    Lobar emphysema shows a hyperlucent lobe, not bowel loops.

  • B. Oesophageal atresia without fistula

    Atresia causes a blind pouch with gasless abdomen in the pure type.

  • C. Congenital diaphragmatic hernia (Bochdalek) (correct)

    Correct. Bowel in the chest with a scaphoid abdomen indicates CDH.

  • D. Hyaline membrane disease

    HMD causes diffuse ground glass opacities and air bronchograms.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is C, Congenital diaphragmatic hernia (Bochdalek). A Bochdalek hernia is a posterolateral diaphragmatic defect, usually on the left, allowing bowel into the chest and causing pulmonary hypoplasia and shift of the mediastinum.

Why is "Congenital lobar emphysema" not the answer?

Lobar emphysema shows a hyperlucent lobe, not bowel loops.

Why is "Oesophageal atresia without fistula" not the answer?

Atresia causes a blind pouch with gasless abdomen in the pure type.

Why is "Hyaline membrane disease" not the answer?

HMD causes diffuse ground glass opacities and air bronchograms.

What concept does this question test?

It tests Chest imaging: diaphragmatic hernia in Radiology. The nasogastric tube lies in the chest if the stomach has herniated. Treatment includes stabilisation followed by surgical repair.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Chest imaging: diaphragmatic hernia?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.